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COTR ID:

UofL ID:

           

Application for Dual Admission

                 
         

Submit to the Registrar’s Office at College of the Rockies (COTR)

               

PERSONAL INFORMATION

                 

13.

COTR Program Details

                   

1.

Name

                       

Program:

(The following names must be your legal names for use on all official UofL documentation. Please PRINT clearly.)

     

Enter the specific program name as shown in the COTR Calendar

 
 

Last Name (Family Name):

   

Admission Status: New Student Continuing Student (Same Program)

 
               

Returning Student (New program)

           
 

First Name:

Former Last Name(s) if applicable:

Preferred Name:

   

Intended Course Load: Full-Time Part-time Full-time Online Part-time Online

Education Goal: Certificate Diploma Associate Degree BBA Other

Date You Wish to Start:

2.

Current Address

           

14.

UofL Program Details

                   

(All correspondence regarding your application will be sent to this address)

Apartment and Street Address:

 

Program: B.A. B.Sc. B.A.Sc. Pre-B.A./B.Ed. Pre-B.Sc./B.Ed.

Major:

   

Second Major (if applicable):

Minor (if applicable):

 

City/Town:

Province/State:

 
 

Country:

                   
 

Postal Code:

Phone:

 

Semester intending to start studies at U of L:

Fall (September)

Spring (January)

 

Year:

   

3.

Permanent Address

                   

PREVIOUS AND CURRENT EDUCATION

           
 

Apartment and Street Address:

 

15.

High School (Secondary) Education

             
           

Include all schools attended for completion of grade 12.

             
     

Name of School:

 
 

City/Town:

Province/State:

Country:

   

City:

Dates Attended:

Province:

Country:

 
           

From:

To:

 
 

Postal Code:

Phone:

         
         

Name of School:

 

4.

Email Address

           

Communication about your application for admission to the UofL will be sent to this email address. Ensure that

   

City:

Dates Attended:

Province:

Country:

 

you check it regularly. After activating your admission, you will receive a UofL email account that will be used to communicate with you.

     

From:

To:

 

5.

Gender/Date of Birth

                                               

Gender:

Female

Male

                 

16.

Post-Secondary Education

               

Date of Birth (dd-MMM-yyyy):

           

Include all post-secondary institutions attended.

Name of School:

 

6.

Country of Citizenship:

   

City:

Dates Attended:

Province:

Country:

 

7.

Immigration Status (Non-Canadian Citizens)

               

From:

To:

 
 

Permanent Resident Live-in Care Giver Student Visa Other Visa:

           

Name of School:

 

8.

First Spoken Language

What is the language you first spoke and still understand?

   

City:

Province:

Country:

 
               

Dates Attended:

To:

 

9.

Aboriginal Ancestry

                       

From:

 

If you wish to declare that you are an Aboriginal person, please specify:

                                     
 

Status Indian/First Nations Métis

Non-Status Indian/First Nations Inuit

         

17.

Application Fees (Payable to COTR): UofL ($100)

COTR ($30)

                 

18.

Declaration of Applicant: With regard to this application, I certify that the particulars

10.

To Act on Your Behalf (Optional)

You may authorize someone to act on your behalf, with respect to admission and registration.

   

furnished are true and complete in all aspects, and no information has been withheld. I understand that falsifying documents or information on this application may result in penalties up to and including

 

Last Name (Family Name):

 

immediate permanent dismissal from the College of the Rockies (COTR) and University of Lethbridge (UofL). I understand that misrepresentation, falsification of documents, and/or the withholding of

 

First Name:

Relationship to the Applicant:

 

requested information in regard to this application are serious offences that may result in prosecution under the U of L Calendar policies and/or the Criminal Code of Canada.

 

Apartment and Street Address:

   

Falsified documents may be shared with other authorities for prosecution under the Criminal Code of Canada, and information regarding applicants who submit falsified documents may be

   

shared with other educational institutions. I understand and agree to the following:

 

City/Town:

Province/State:

   

I authorize the UofL to request from and/or verify with other institutions any of my transcripts,

 

Postal Code:

Phone:

   

in addition to those already submitted, directly or through ApplyAlberta. I authorize the College of the Rockies to release my personal information, registration status,

APPLICATION DETAILS

                   

and any and all official transcripts received to the UofL to facilitate my dual admission and registration at the UofL. I understand that the UofL reserves the right to request these documents directly.

11.

Have you ever been Required to Withdraw from a program by any

   

If admitted to the UofL, I agree to comply with the regulations of the UofL. I understand my

post-secondary institution?

   

admission will not be final until my file is complete and all required documents have been received.

Yes: Institution:

No

             

Further, I agree to the disclosure of information described at the bottom of this page.

12.

Co-operative Education

                   

Are you interested in the Co-operative Education Program at the UofL? Yes

No

 

Signature of Applicant

       

Date of Application

   

University of Lethbridge: The personal information on this form is collected under the authority of the Post-secondary Learning Act (Alberta) and the Freedom of Information and Protection of Privacy Act (Alberta) and will be used to determine your eligibility for admission and registration. Upon admission to the University, your information may be shared with academic and administrative units to administer scholarships and awards, student services, planning and research, and alumni relations. Specific data will also be disclosed to the Federal and Provincial Governments to meet reporting requirements, and to the relevant student associations. For questions on the collection, use and disclosure of this information, please contact the University’s FOIP Coordinator at foip@uleth.ca or 403-332-4620.

Available UofL Programs and Majors

Available UofL Programs and Majors